套管针穿刺胸膜腔闭式引流术治疗大量胸腔积液临床疗效观察

Trocar Puncture of Pleural Cavity Closed Drainage for the Treatment of Pleural Effusion

目的:评估套管针穿刺胸膜腔闭式引流术治疗大量胸腔积液的疗效。方法:选取我院收治的68例胸腔积液患者作为研究对象,根据不同的手术方式分为观察组与对照组,每组各34例。其中观察组行套管针穿刺胸膜腔闭式引流术,对照组行传统反复胸腔穿刺引流术,比较两组患者的各治疗指标与术后并发症发生率。结果:观察组胸腔积液吸收时间为(5.24±1.67)d,胸膜增厚(4.93±2.52)mm,较对照组相比有显著改善,差异有统计学意义(P<0.05),而两组总引流量无显著性差异(P>0.05)。观察组患者胸引管留置时间与住院时间明显低于对照组,观察组患者术后12h、24h与36h的NRS评分值均低于对照组,提示观察组患者术后疼痛程度较对照组相比有明显降低,差异有统计学意义(P<0.05)。同时,观察组术后并发症总发生率为17.65%;对照组术后并发症总发生率为44.12%,观察组患者术后并发症发生率明显低于对照组(P<0.05)。结论:套管针穿刺胸膜闭式引流术治疗大量胸腔积液疗效显著,可加快患者恢复,减轻患者痛苦,降低术后并发症发生率,值得临床推广。

Objective： To investigate the effect of trocar puncture of pleural cavity closed drainage for the treatment of pleural effusion. Method： 68 patients with pleural effusion were selected as the research object, according to the different operation, which were divided into observation group and control group, with 34 cases in each group. The observation group was received trocar puncture of pleural cavity closed drainage, while the control group was received the traditional pleural puncture drainage.The therapeutic index and the incidence of postoperative of two groups were compared.Result： In the observation group, the pleural effusion absorption time was （5.24± 1.67 ） days, pleural thickening （4.93±2.52） mm, the difference was statistically significant compared with the control group （ P 〈 0.05 ） , while the total flow rate of the two groups had no significant difference （P 〉 0.05 ）. The chest tube indwelling time and hospitalization time of patients in observation group was significantly lower than the control group, and NRS score of observation group after 12 hours, 24 hours and 36 hours were statistically lower than the control group （P 〈 0.05 ）. At the same time, the total incidence of postoperative complications in observation group was 17.65%, while the postoperative complications incidence of the control group was 44.12%, the difference was statistically significant （ P 〈 0. 05） .Conclusion： Trocar puncture pleural closed drainage for the treatment of pleural effusion has definite therapeutic effect, which could speed up the recovery, relieve patients＇ pain and reduce the incidence of postoperative complications, which is worthy of clinical application.